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Last year NHS England recommended doctors no longer prescribe any homeopathic or herbal remedies, although some GPs continue to do so. The British Homeopathic Association is taking NHS England to court to try to overturn its decision, with a judicial review set for 1 May.

Defenders of homeopathy often claim that as these remedies tend to be relatively cheap, they avoid the use of more expensive conventional medicines.

The latest study looked at all the 7618 primary care practices in England with data available on a website called Open Prescribing, which analyses use of medicines within the NHS. It was developed by Ben Goldacre of the University of Oxford and colleagues.

Goldacre’s team found that 644 practices had issued one or more homeopathy prescriptions in a six-month period ending in 2017; these had slightly worse composite scores obtained by judging them on 70 standards of good practice in prescribing. The findings may reflect a lack of respect for evidence-based practice, says Goldacre.

As well as overusing antibiotics, benchmarks also included using ineffective doses of cholesterol-lowering drugs and using expensive brand-name medicines instead of ones that are available in cheaper generic forms.

But homeopathy-favouring GPs scored about the same as other doctors on quality measures unrelated to prescribing, such as the percentage of patients who would recommend the practice to their friends.

Peter Fisher, president of the Faculty of Homeopathy, says other studies have shown GPs who use these remedies tend to prescribe fewer antibiotics. “We don’t know if these measures correlate with what matters to patients – whether they get better and have side-effects.”